The Humanization of Healthcare Treatments and Critical Choices




© Springer-Verlag Italia 2015
Edward Callus and Emilia Quadri (eds.)Clinical Psychology and Congenital Heart Disease10.1007/978-88-470-5699-2_2


2. The Humanization of Healthcare Treatments and Critical Choices



Francesco Campione 


(1)
Psychology Department, University of Bologna, Viale Berti Pichat 5, Bologna, BO, 40100, Italy

 



 

Francesco Campione



“Humanizing” means “making human” in two ways:

(a)

Making what a human being lives through human (and not brutal, inhuman, etc.)

 

(b)

Making the ones who live, human, i.e., ensuring that individuals behave humanly with themselves and especially with others

 

As a result, the dignity [1] of a human being (that his/her life is given value to and is such that it is worthy to be lived) derives from his/her living experiences worthy of a human being and by his/her behaving in a manner worthy of a human being.

But what defines a “human”? Under what conditions we can consider “human” the life of a human being? When can we say that a human being is behaving in a human way towards another human being?

Being human can be defined in objective terms, in subjective terms, or in intersubjective terms.

In objective terms, the human can be defined as a biological being who, through evolution, came to possess a brain which is more evolved than all other living beings and who is the only one in possession of self-awareness and language.

In subjective terms, the human can be defined as a personal being characterized by a biography that makes him/her unique and not comparable with any other personal being.

In intersubjective terms, the human can be defined as a human being, i.e., firstly belonging to a species precisely humankind, characterized by an original and unsurpassed interconnection between all minds, all languages, all self-awarenesses, and all the biographies.

In other words:

(a)

The conditions of the human being can depend on objective factors (the functioning of the brain, self-awareness, and the use of language that rely on it), that is, the human will be the sum of the products of the human brain, the human will correspond to objective rationality characteristics pertaining to men’s thoughts, and this is something that concerns all men and belongs to all men and also something that does not belong to anyone in an exclusive manner.

 

(b)

The conditions of the human being may depend on subjective factors (the lived biographical experience of every person), so that the human will be what each one, from his/her point of view, tells themselves they are, and everyone will be a man or a woman in their own way, and this is something that pertains to everyone as it belongs to them.

 

(c)

The conditions of the human may depend on intersubjective factors (the meanings arising from encounters between individuals), so that the human will be the ensemble of what the other strikes in us and affects us without belonging to us, that which is “beyond” the objective rationality of our thought and “beyond” the particular perspective of our personal biography.

 

In fact:



  • There are those who feel that they are men only if their brains are functioning, if they have self-awareness, and if they can express themselves; otherwise, they consider their life “inhumane” and unworthy of being lived (being men therefore means being normal, functioning, and as biological beings belonging to a certain species).


  • There are those who feel men as long as they recognize themselves, until they feel themselves, regardless of the objective functioning of their brain, a realistic self-awareness and a normal way of expressing themselves (indeed, sometimes it’s just a little bit of madness, a distorted self-awareness, and a particular way of expression that leads to a unique and unrepeatable identity). For them, life becomes inhuman and unworthy to be lived when they no longer feel themselves, whatever this means (being men therefore means being someone distinguishable from all others, with a proper identity which makes one feel oneself).


  • There are those who feel men when they encounter others and feel that something about these individuals concerns them as also something about them concerns others. They feel this way regardless of the fact that others are similar or different from them when it comes to biological functioning or personal identity, i.e., irrespective of belonging to the same category of biological beings (the clever or the stupid) or personal beings (pleasant or nasty people) (being human therefore means being there for someone else and not only for oneself).

The truth is, of course, that these three dimensions of the human “make” man all together, but there is no concrete humanity that does not necessitate some sort of “hierarchy” to be established between them. This is so because in the absence of such a hierarchy, man could not be educated to be “human” but would become so chaotic and in a conflictual manner without any hope of becoming truly human, i.e., to organize in a harmonious unity all his/her dimensions.

In contemporary western culture, after centuries of prevalence of the personal being on the biological being and of the biological being on the human being, the hierarchy that tends to prevail is that which places the biological being before the personal being and the personal being before the human being. But the personal factor is still very strong especially in Latin subcultures.

The most evident consequence of this is the prevalence of scientific knowledge (according to which to know man, it is essential to know the functioning of the brain, neuroscience) on “humanistic” knowledge (according to which to know man, it is essential to know the feelings of each man or of mankind in general).

The consequence of this setting when it comes to healthcare is that when an individual falls ill or suffers, in my opinion, it would be desirable to promote an “ethical prevalence” of the human being on the personal being and of the personal being on the biological being.

The first consequence for those who become ill is to become a “clinical case,” which can be inserted into a statistic, the only way to take into consideration their characteristics as something that belongs to all of us and affects us all, with an individual variability of a quantitative type with respect to a “normal” distribution in the population. In this way, the personal characteristics which make ill people unique (their personality and biography) and human (their interpersonal relationships) are pushed into the background. This is inevitably followed by a certain degree of “depersonalization” and “dehumanization.” Not too much damage is done if this depersonalization and dehumanization lasts for a short time and if in this time, through the techniques of medicine, the goal of healing is reached. On the other hand, when medicine reaches its limit, and there is a failure to heal the individual, depersonalization and dehumanization can be prices that are too high to pay in terms of “loss of dignity of life” for patients who base their value on the “personal feeling of being themselves and unique” and on those who base it “on the consideration of others.”

The prices to be paid and the manner in which they are paid have been outlined previously in the “Manifesto for the humanization of medicine” [2]:

…In sickness, we all live the insult to the integrity of our body (integrity that is the basis of the possibility to build a personal history) and the humiliation in the pride to exist (pride that is the basis of the ability to respect and to be respected). And when we are ill, we all invoke a medicine that has the power to heal, to alleviate pain and to prevent the threat of death. But medicine is not able to counteract this offense and this humiliation, if not in the rare cases in which it helps us to achieve a complete and lasting healing. This is so because, in order to help us, Medicine is in possession only of its technical power. As if to say that to overcome the offense that disease incurs to the dignity of the person and the humiliation to the dignity of man, Medicine possesses an uncertain and therefore anonymous statistical power to restore health. However, it is the insult and humiliation of the illness that the uncertain power of the doctor is unable to effectively overcome, because it almost never heals permanently. This injury and humiliation will be able to be counteracted if Medicine will give the offended person and the humiliated humanity of the ill a moral value higher both than that of the personal being and of the humanity of the healthy person and also of Medicine itself. In other words, the doctor should recognize the moral majesty of the ill precisely in the offense, in the humiliation that the disease inflicts, therefore putting his/her technique to the service of the sick person’s dignity as a person and as a man!

But what gives dignity to the sick, as a person and because they belong to the human race? This is what every human being shares with all other human beings and that what gives it meaning with his/her personal differences but it also goes beyond these differences. This is about the possibility that every sick man has to stir in another human being the responsibility of taking care of him/her by asking him/her for help.

It then becomes important to empathize with patients in order to be inspired by them (allow them to tell) to do and say what could “compensate” the loss of dignity of life determined by depersonalization and dehumanization. It is a concrete operation of appreciation; it refers to everything that gives value to each one of us as a human being, regardless of our biology and of us “being a person.” Simone Weil [3] stated that the value of each person, whoever he or she is, is based on their “desire for good.” This is what was described in the cited “Manifesto for the humanization of medicine” [2] in the following manner: “It is important to ensure that the moral superiority of the ill (compared to those who assist them) is also recognized by the ill people themselves, placing as a focal point of the doctor’s care the restoration of the ill person’s dignity even when (and especially when) it is not possible to achieve this objective through healing. For this to occur, it is essential to ensure that the training of doctors (and the entire medical staff) is no longer predominantly technical and that they are no longer blackmailed economically but that they are trained to become what they always have been and what they always wanted to be in their most authentic and most noble vocation: the guardian of life and the dignity of the ill person in spite of any economic compatibility and kind of power whatsoever. It is also important to aid those who are momentarily healthy and gain awareness that when the offense and humiliation of disease occur, for everyone sooner or later, it is possible to adopt more effective defensive strategies than medical technologies: the sharing of a collective moral principle that those who suffer “ are worth more morally” than those who do not suffer or those who suffer for them, a principle that can inspire the responsibility of a doctor capable of a technical act which is not self-sufficient but always at the service of the sick person and the humanity of the ill person.”

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Dec 3, 2016 | Posted by in PSYCHOLOGY | Comments Off on The Humanization of Healthcare Treatments and Critical Choices

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